Literature DB >> 23522873

Influence of insulin sensitivity and secretion on glycated albumin and hemoglobin A1c in pregnant women with gestational diabetes mellitus.

Jiemin Pan1, Feng Zhang, Lei Zhang, Yuqian Bao, Minfang Tao, Weiping Jia.   

Abstract

OBJECTIVE: To examine the differential effects of insulin sensitivity and secretion on hemoglobin A1c (HbA1c) and glycated albumin (GA) at 24-32weeks of pregnancy in women with gestational diabetes mellitus (GDM).
METHODS: A cross-sectional, sequential case series study was performed in pregnant women with an abnormal 50-g oral glucose-screening test. Hemoglobin A1c and GA measurements were taken during oral glucose tolerance test (OGTT). The homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-%β), insulin sensitivity index (ISOGTT), and modified insulinogenic index were calculated to assess insulin sensitivity and secretory function.
RESULTS: A total of 713 pregnant women were enrolled. The GDM group had lower ISOGTT and insulinogenic index scores, and a higher HOMA-IR score. Hemoglobin A1c was positively correlated with HOMA-IR. Glycated albumin was negatively correlated with insulinogenic index and HOMA-%β. Multiple regression analysis revealed that HbA1c was independently associated with diastolic pressure, 0- and 120-minute glucose, and HOMA-IR; GA was independently associated with 0- and 120-minute glucose.
CONCLUSION: Compared with HbA1c, GA is more closely correlated with fasting and postprandial glucose, regardless of insulin resistance and blood pressure, and might be a better monitoring index in women with GDM.
Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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Year:  2013        PMID: 23522873     DOI: 10.1016/j.ijgo.2013.01.017

Source DB:  PubMed          Journal:  Int J Gynaecol Obstet        ISSN: 0020-7292            Impact factor:   3.561


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